Confusion re ttc after ectopic

Looking for some help as feeling a bit confused.

Got diagnosed with an ectopic pregnancy 13th August after 1 week of brown discharge and 1 week of bleeding. Treatment option offered was the injection and so far hcg levels are slowly coming down. Been told I will be discharged when they are below 20.

Here are a few things that I’m confused about-

  1. Can I take the folic acid after my numbers have reduced to below 20 but within the 3 month time frame of having mtx?
  2. I know I need to wait 3 months after mtx but I read online that your body cannot store folate so why do I need to take folic acid 3 months before I’m trying to conceive when my body doesn’t store it?
  3. I asked if they would scan me again to see if it’s gone and got told no as its all down to the hcg and it can still be there even when the hcg is below 20. Potentially really stupid question but if I then ovulate from my right ovary won’t the egg just get stuck behind the blockage if it’s still there. And even worse if a swimmer gets through and fertilises it won’t we be in the same situation again?

Im finding all of this really hard to process and seem to be going down many rabbit holes on the Internet looking for reasons, solutions and trying to deal with anxieties of this not happening again.

Hi Ktwigs,

I am so sorry to hear of your ectopic pregnancy and loss. While I’m not medically qualified to comment on your particular situation, I will do my best to help.

We and other medical professionals advise you wait for three months or two full menstrual cycles (periods) before trying to conceive to allow your cycle to return and there to be a clear Last Menstrual Period (LMP) date to date a new pregnancy from – information that is invaluable in ensuring you are not suffering from another ectopic pregnancy in the future.

This wait also allows the internal inflammation and bruising from the ectopic and any associated treatment to heal, and for the necessary process of grief to surface and be worked through. Some studies do suggest that women who conceive immediately after treatment for ectopic pregnancy are more at risk of suffering a subsequent ectopic.

With regards to methotrexate, if you have had either one or two injections, you should wait until your hCG levels have fallen to below 5mIU/mL and then take a folic acid supplement for 12 weeks before you try to conceive.

This is because the Methotrexate may have reduced the level of folate in your body, which is needed to ensure a baby develops healthily. Methotrexate is metabolized quickly, but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works, and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects.

I know this waiting time can be quite difficult and frustrating, but I hope the information clarifies why we advise waiting.

Please know that you are not alone. These boards are filled with women and men who understand. We are here for as long as you need.

With good wishes,

Michele

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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Hi, sorry to jump on this thread but your reply mentioned ‘some studies do suggest that women who conceive immediately after treatment for ectopic pregnancy are more at risk of suffering a subsequent ectopic’ - please could you point me to this research? Thanks.